JCPSLP Vol 18 No. 1Mar 2016

Patientsidentifiedover5weeks n = 233

Not a stroke n = 202 (86.7%)

Confirmed stroke n = 31 (13.3%)

Confirmed stroke Screened n = 23 (74.2%)

Confirmed stroke Unable to be assessed n = 8 (25.8%) Reason for no assessment:

• Dischargedpriortoreview4(50%) • Diagnoseddegenerativeneurological condition 3 (37.5%) • Stroke due to cerebral metastases 1 (12.5%)

No aphasia as determined by FAST or clinical diagnosis n = 14 (60.9%)

Confirmed aphasia as determined by FAST and clinical diagnosis n = 9 (39.1%)

Referred to speech pathology n = 9 (100%)

Not appropriate for therapy n= 1 (11.1%)

Appropriate for therapy n = 8 (88.9%)

Reason for no therapy: • Reduced alertness

Received aphasia therapy n = 4 (50%)

Received no aphasia therapy n = 4 (50%)

Reason for no therapy: • Reducedmood&reducedparticipation in session n = 2 (50%) • No reason given 2 (50%)

Figure 1. Identification and screening results for all hospital admissions with a possible diagnosis of stroke, and speech pathology management for participants with a confirmed stroke.

other services (counselling, education to individual or family, planning) in the management of participants with aphasia is outlined in Figure 3. The figure presents combined data regarding the management of aphasia, dysphagia, dysarthria, dyspraxia, and voice disorders. Discussion and conclusions Within this study just over one-third of patients admitted with stroke over a 5-week period were diagnosed with post-stroke aphasia. This incidence is similar to results from previous research (Ciccone et al., 2015; Dickey et al., 2010; Lalor & Cranfield, 2004; Law et al., 2009). All participants with aphasia were referred to speech pathology by the treating medical team and individuals tolerated commencing therapy as early as 3 days post-stroke. These individuals received a total average of 44 minutes of aphasia therapy per week which is less than the 2 hours of therapy per week recommended in the National Stroke Foundation (2010) clinical guidelines for stroke management. It is noted the rate of referral to speech pathology is greater than the referral rate found in Lalor and Cranfield (2004), which was less than 25%. Additionally, the minutes of aphasia therapy provided per week is greater than reported previously in Godecke et al. (2011) who found people with aphasia received an average of 14 minutes of therapy per week.

Table 2. Average number of sessions and time spent in assessment and therapy M (range)

Aphasia Dysphagia Other

No.participantsassessed

8

4

2

No.assessmentsessions

3.13 (1–9)

3.75 (2–5)

3 (3–5)

Length of assessment sessions (mins) No.participantsreceiving therapy

34.9 (8–60)

13.2 (5–20)

11.7 (5–10)

4

2

2

No. therapy sessions

2.5 (1–5)

5 (3–7)

4 (1–7)

Length of therapy sessions (mins)

29 (10–60)

11 (5–20)

14.8 (10–30)

Note: Other = dysarthria, apraxia, and voice.

For the individuals with aphasia, the amount of time speech pathologists allocated to aphasia management overall was greater than the time allocated to the management of dysphagia. Interestingly, speech pathologists delivered three times more aphasia assessment than therapy. When

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JCPSLP Volume 18, Number 1 2016

Journal of Clinical Practice in Speech-Language Pathology